使用止血带与不使用止血带的高位胫骨截骨术效果比较。

Comparison of the effects of high tibial osteotomy with and without a tourniquet.

作者信息

Wu Huiwen, Wang Fangyuan, Deng Shihao, Liang Shuai, Lan Shaoze, Sun Kenan, Lunzhu Ciren, Cangjue Dawa, Li Jun

机构信息

Department of Orthopaedics, The Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, China.

Institute of Orthopaedics, Research Center for Translational Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, China.

出版信息

BMC Surg. 2024 Dec 19;24(1):388. doi: 10.1186/s12893-024-02681-z.

DOI:10.1186/s12893-024-02681-z

PMID:39702295

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11658392/

Abstract

BACKGROUND

Tourniquets are routinely employed to achieve hemostasis in modern limb surgeries. Nevertheless, the precise role and benefits of tourniquets in high tibial osteotomy (HTO) surgeries remain understudied. The aim of this study was to assess the application of tourniquets in high-tibial osteotomy procedures.

METHODS

This was a prospective study of patients who underwent HTO surgery at an identical hospital. The participants were randomly assigned into two groups: Group A, with a tourniquet (n = 43); and Group B, without a tourniquet (n = 43). The same surgical technique and postoperative care were employed for both groups of patients. Knee range of motion (ROM) and pain were assessed by utilizing a visual analogue scale (VAS) after exercise and maximum calf circumference, and postoperative Hospital for Special Surgery (HSS) score, as well as inflammatory markers including CRP and IL-6, were adopted to compare and analyse the recovery of knee function in the two groups of patients following surgery.

RESULTS

All participants were followed up for a period exceeding three months. No cases of vascular or nerve injuries were observed during surgery in either group. Moreover, there was no statistically significant difference in total blood loss volume throughout treatment or haemoglobin or haematocrit levels (P > 0.05). furthermore, Group A underwent a shorter operation than Group B did (P < 0.05). Group B demonstrated decreased postoperative visual analog scale (VAS) pain levels, calf swelling (P < 0.05), increased early knee range of motion (P < 0.05), and diminished release of blood inflammation markers(IL-6 and CRP) (P < 0.05).

CONCLUSION

The application of tourniquets in HTO surgery reduces intraoperative blood loss and shortens the operative time yet does not substantially affect total bleeding. Nonetheless, the absence of a tourniquet resulted in reduced postoperative pain and facilitated early rehabilitation of knee function.

摘要

背景

在现代肢体手术中，经常使用止血带来实现止血。然而，止血带在高位胫骨截骨术（HTO）手术中的具体作用和益处仍未得到充分研究。本研究的目的是评估止血带在高位胫骨截骨手术中的应用。

方法

这是一项对在同一家医院接受HTO手术的患者进行的前瞻性研究。参与者被随机分为两组：A组，使用止血带（n = 43）；B组，不使用止血带（n = 43）。两组患者均采用相同的手术技术和术后护理。通过运动后视觉模拟量表（VAS）评估膝关节活动范围（ROM）和疼痛，以及最大小腿周长，并采用术后特种外科医院（HSS）评分以及包括CRP和IL-6在内的炎症标志物，来比较和分析两组患者术后膝关节功能的恢复情况。

结果

所有参与者均接受了超过三个月的随访。两组手术过程中均未观察到血管或神经损伤病例。此外，整个治疗过程中的总失血量、血红蛋白或血细胞比容水平均无统计学显著差异（P > 0.05）。此外，A组的手术时间比B组短（P < 0.05）。B组术后视觉模拟量表（VAS）疼痛水平降低、小腿肿胀减轻（P < 0.05），早期膝关节活动范围增加（P < 0.05），血液炎症标志物（IL-6和CRP）释放减少（P < 0.05）。